32.1.7 Evaluation of Electrolytes and Renal Function in Patients with Hyperthyroidism in Mirpur AJK

Original Article

 

Electrolytes and Renal Function with Hyperthyroidism

Evaluation of Electrolytes and Renal Function in Patients with Hyperthyroidism in Mirpur AJK

Rashad Mahmood1, Khuram Shahzad Khan1, Zara Shaukat4, Faisal Bashir2 and Asnad3

ABSTRACT

Objective: The objective of this study to evaluate electrolytes and renal function in patients with Hyperthyroidism in Mirpur AJK.

Study Design: Cross-sectional study

Place and Duration of Study: This study was conducted at the Department Physiology and Biochemistry Department of Mohtarma Benazir Bhutto Shaheed Medical College Mirpur AJK from January 2018 to July 2019.

Materials and Methods: We take for study 200 hyperthyroid patients’ and 100 health Control. Samples were centrifuged at 3000RPM for 10 min. T3, T4 and TSH were measured by Special Chemistry Analyze. Serum creatinine (Cr), blood urea nitrogen (BUN), uric acid (UA) was analyzed by Micro lab 300 and used Merk Kits. Sodium (Na), Potassium (K), and Chloride were analyzed by Electrolyte Analyzer and used Merk Kits. Statistically analysis by SPSS version 20 software for ANOVA.

Results: Result showed that in hyperthyroid patients’ Uric acid (4.8±1.3) and Creatinine (0.5±0.4) mean concentration were lower as compared to control. The concentration of  urea were normal in hyperthyroid patients and control both while the concentration of eGFR  (203.2±103.8) was higher  in hyperthyroid patient as compare to control. The concentration of Sodium   (139.7±2.2) was higher in hyperthyroid patient as compare to control.

Conclusion: The present study demonstrated the hyperthyroidism are linked with alteration and changes of renal functions and also alter the electrolyte balance. Hormonal balance should be corrected properly

Key Words: electrolytes, renal function, Hyperthyroidism

Citation of article: Mahmood R, Khan KS, Shaukat Z, Bashir F, Asnad. Evaluation of Electrolytes and Renal Function in Patients with Hyperthyroidism in Mirpur AJK. Med Forum 2021;32(1):30-32.

 

 

INTRODUCTION

There is correlation exist between kidney and thyroid.  The renal physiology of the person affects with thyroid dysfunction and also develops other abnormality and also caused renal failure. 1 Most common disorders Hyper- and hypothyroidism are exist in the entire world. 5% of the general population is with Hypothyroidism and primary hypothyroidism 99% affected patients.  Depending on the  concentration of T3 and T4 in the blood  which is correlate  with  abnormalities of  the synthesis of these hormone because  in the abnormality of these hormones caused renal dysfunction and imbalance of electrolyte  of the person. 2-5

 

 

1. Department of Physiology/ENT2/ Biochemistry3, Mohtarma Benazir Bhutto Shaheed Medical College, Mirpur, AJK.

4. Department of Physiology, Foundation University Islamabad Campus.

 

 

Correspondence: Dr.  Asnad, Associate Professor of Biochemistry, Mohtarma Benazir Bhutto Shaheed Medical College, Mirpur, AJK.

Contact No: 0332-3698204

Email: drasnadkhan@gmail.com

 

 

Received:  June, 2020

Accepted:  October, 2020

Printed:      January, 2021

 

 

Deficiency of thyroid hormone   caused hypothyroidism and it is affects the metabolic process which is clinically and biochemical disorder.6 Hypothyroidism is also associated with other biochemical abnormalities uric acid and serum creatinine increased .7

It is also observed that some other physiological changes are occurred such as renal blood flow are reduced and sodium, chloride and water and glomerular filtration rate are affected.8 Chronic kidney disease (CKD)  is  caused by hyperthyroidism by many mechanism and overall system is enhanced of kidney increased filtration rate  and renal injury  caused proteinuria and hyperthyroidism  also  enhanced  the energy metabolism and also increased  free radicals  generation.9 In the present study we evaluate  electrolyte and renal function  in patients with thyroid dysfunction in Mirpur AJK.

MATERIALS AND METHODS

We take for study 200 hyperthyroid patients’ and 100 health Control. The study was conducted in the department of Physiology and Biochemistry Department of Mohtarma Benazir Bhutto Shaheed Medical College Mirpur AJK.

Samples were centrifuged at 3000RPM for 10 min. T3, T4 and TSH were measured by Special Chemistry Analyze. Serum creatinine (Cr), blood urea nitrogen (BUN), uric acid (UA) was analyzed by Micro lab300 and used Merk Kits. Sodium (Na), Potassium (K), and Chloride were analyzed by Electrolyte Analyzer and used Merk Kits. Statistically analysis by SPSS version 20 software for ANOVA.

RESULTS

In this study, we were selected 200 hyperthyroid patients’ and 100 normal health control for research work.

Result showed that in hyperthyroid patients’   Uric acid (4.8±1.3) and Creatinine (0.5±0.4) mean concentration were lower as compared to control. The concentration of  urea were normal in hyperthyroid patients and control both while the concentration of eGFR (203.2±103.8) was higher  in hyperthyroid patient as compare to control.

The concentration of Sodium   (139.7±2.2) was higher in hyperthyroid patient as compare to control.

Table No.1:  Participant Characteristics

 

Hyperthyroid patients’(n=200)

Control  (n=100)

Age (years)

40.54 ± 10.48

40.55 ± 10.38

Education

Basic

B-50%,

B-50 %

Secondary

S-25%

S- 31%

University

U-25%

U-19%

Body weight (Kg)

69.1 + 11.4

70.4 + 11.5

BMI (kg/m2)

25.3 + 2.6

25.4 + 2.7

B: Basic, S: Secondary, U: University

Table No.2: Renal Function of Hyperthyroid patients’ and Control health participants

Hyperthyroid patients’   (n=200)

Control  (n=100)

Urea (mg/dl)

24.3±14.8

21.8±10.5

Creatinine(mg/dl)

0.5±0.4

0.8±0.5

Uric Acid (mg/dl)

4.8±1.3

5.6±1.9

eGFRml/min

203.2±103.8

116.8±41.6

Table No.3: Electrolyte balance of hyperthyroid patients’ and Control health participants

Hyperthyroid patients’   (n=200)

Control  (n=100)

Sodium mmol/L

139.7±2.2

136.4±3.3

Chloride mmol/L

106.5±5.0

104.6±2.7

Calcium  mmol/L

9.4±0.5

9.4±0.5

Potassium  mmol/L

4.3±0.5

4.4±0.9

DISCUSSION

In different studies showed that there is association exist between abnormal renal function tests and thyroid dysfunction. Creatinine, and uric acid are observed decreased in hyperthyroid patients in the present study and enhanced eGFR value significantly. Our study showed similarity with some other study in which eGFR, Urea and Creatinine changes observed .11There is correlation exist between kidney and thyroid.  The renal physiology of the person affects with thyroid dysfunction and also develops other abnormality and also caused renal failure.  Most common disorders Hyper- and hypothyroidism are exist in the entire world.  5% of the general population is with Hypothyroidism and primary hypothyroidism 99% affected patients.  Depending on the  concentration of T3 and T4 in the blood  which is correlate  with  abnormalities of  the synthesis of these hormone because  in the abnormality of these hormones caused renal dysfunction and imbalance of electrolyte  of the person. Deficiency of thyroid hormone   caused hypothyroidism and it is affects the metabolic process which is clinically and biochemical disorder. Hypothyroidism is also associated with other biochemical abnormalities uric acid and serum creatinine increased .It is also observed that some other physiological changes are occurred such as renal blood flow are reduced and sodium, chloride and water and glomerular filtration rate are affected. Chronic kidney disease (CKD)  is  caused by hyperthyroidism by many mechanism and overall system is enhanced of kidney increased filtration rate  and renal injury  caused proteinuria and hyperthyroidism  also  enhanced  the energy metabolism and also increased  free radicals  generation. GFR increases in in hyperthyroid patients with positive effects of chronotropic and intro tropic of cardiac output.12,13In hyperthyroid cases, eGFR is increased, growth factor type-I like Insulin .14, 15We take for study 200 hyperthyroid patients’ and 100 health Control. The study was conducted in the department of Physiology and Biochemistry Department of Mohtarma Benazir Bhutto Shaheed Medical College Mirpur AJK Samples were centrifuged at 3000RPM for 10 min. T3, T4 and TSH were measured by Special Chemistry Analyze. Serum creatinine (Cr), blood urea nitrogen (BUN), uric acid (UA) was analyzed by Micro lab 300 and used Merk Kits. Sodium (Na), Potassium (K), and Chloride were analyzed by Electrolyte Analyzer and used Merk Kits.   Increased secretion of uric acid link to enhanced concentration of thyroid hormones, which cause increase rate  purine metabolites  and increased the production of uric acid and renal work is enhanced to  excrete uric acid.16In the present study serum creatinine is decreased  which is against to other  previous  studies  in which increased serum creatinine value were found  due to a decrease in eGFR.17,18Result showed that in hyperthyroid patients’   Uric acid (4.8±1.3 ) and Creatinine (0.5±0.4) mean concentration were lower  as compared to control. The concentration of  urea were normal in hyperthyroid patients and control both while the concentration of eGFR  (203.2±103.8) was higher  in hyperthyroid patient as compare to control. The  concentration of Sodium   (139.7±2.2) was higher  in hyperthyroid patient as compare to control In hyperthyroidism, increased thyroid hormones, increased sodium ions significantly and all segments of nephron proximal tubules, activity of Na-Pico-transporter and Na-H exchanger increased19-21.In the case of hypothyroidism, electrolyte balance decreased in hypothyroidism  but   statistically  not significant.22The present study demonstrated the hyperthyroidism are linked with alteration and changes of renal functions and also alter the electrolyte balance. Hormonal balance should be corrected properly.

CONCLUSION

The present study demonstrated the hyperthyroidism are linked with alteration and changes of renal functions and also alter the electrolyte balance. Hormonal balance should be corrected properly.

Author’s Contribution:

Concept & Design of Study:

Rashad Mahmood

Drafting:

Khuram Shahzad Khan, Zara Shaukat

Data Analysis:

Faisal Bashir, Asnad

Revisiting Critically:

Rashad Mahmood, Khuram Shahzad Khan

Final Approval of version:

Rashad Mahmood

Conflict of Interest: The study has no conflict of interest to declare by any author.

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